Working Papers No. 143/10

Exotic Drugs and English Medicine: England’s Drug Trade, c.1550-c.1800

.

Patrick Wallis

© Patrick Wallis, LSE

July 2010

Department of Economic History London School of Economics Houghton Street London, WC2A 2AE Tel: +44 (0) 20 7955 7860 Fax: +44 (0) 20 7955 7730

Exotic Drugs and English Medicine: England’s Drug Trade, c.1550-c.18001

Patrick Wallis

Summary: What effect did the dramatic expansion in long distance trade in the early modern period have on healthcare in England? This paper presents new evidence on the scale, origins and content of English imports of medical drugs between 1567 and 1774. It shows that the volume of medical drugs imported exploded in the seventeenth century, and continued growing more gradually over the eighteenth century. The variety of drugs imported changed more slowly. Much was re-exported, but estimates of dosages suggest that some common drugs (e.g.: senna, Jesuits’ bark) were available to the majority of the population in the eighteenth century. English demand for foreign drugs provides further evidence for a radical expansion in medical consumption in the seventeenth century. It also suggests that much of this new demand was met by purchasing drugs rather than buying services.

What effects did the dramatic expansion in long distance trade in

the early modern period have on healthcare in England? European

demand for drugs and spices is widely recognised as one of the driving

forces of international commerce. While the volume and price of the major

spices such as pepper and cloves have been much studied, the impact

that increasing levels of trade had on the wider array of primarily medical

drugs and its consequences for medical practice is largely unknown.2

Beyond some import figures for 1567 to 1638 compiled by Roberts, and

Davis’ aggregate values for drug imports over the eighteenth century, no

estimates exist for English imports or consumption.3 This neglect is

1 Acknowledgements to follow. Research Assistance: Carlos Santiago Caballero; Elizabeth Williamson; Carlos Brando; Nat Ishino. 2 Recent discussions include: Findlay and O’Rourke 2007; O’Rourke and Williamson, 2002; O’Rourke and Williamson, 2009; Halikowksi Smith 2008. 3 Roberts 1965; Davis 1954; Davis 1962.

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surprising given the importance of imported goods such as sugar, tea,

tobacco, and calicos to analyses of consumption more generally, and the

growing interest in perceptions of exotic drugs and their impact on natural

philosophy.4

In this paper, I present new evidence on the trajectory of the

English medical drug trade between 1567 and 1774 showing that

consumption of imported medical drugs exploded in the seventeenth

century and continued growing more gradually over the eighteenth

century. Medicines flooded in alongside other commodities as England

moved from being the last step on a long supply chain that crossed

Europe and the Levant to a major entrepôt for the rest of the continent.

This account of medical drugs has relevance to general histories of

consumption: by considering the full range of old and new medical drugs

imported it allows an insight into the significance of novelties in inspiring

consumption, and by covering a longer period than most studies it permits

longer run trends to be identified. More specifically, understanding the

dramatic changes in the volume and type of drugs that were imported

between the sixteenth and eighteenth centuries allows us to engage with

two central issues in the history of early modern medicine. The first is the

timing and scale of the shift in English demand for commercially-supplied

healthcare. The second is whether the very significant theoretical

changes in medicine in this period were reflected in what people used as

drugs: or how quickly, and how extensively, was the character of

medicine changing?

The availability of imported drugs offers a distinctive measure of

healthcare consumption. Most studies to date have focussed on the

personnel supplying healthcare rather than the materials involved,

4 On consumption: Peck 2005; Berg 2005; De Vries 2008; McCants 2007. On natural philosophy and exotics: Smith and Findlen 2002; Cook 2008, pp. 191-225; Winterbottom, 2009; Anagnostou, 2007.

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exploring the density of practitioners, the activities of particular individuals

and groups of medical practitioners, and, more recently, the frequency of

resort to practitioners among the seriously ill.5 By developing this last

method, Ian Mortimer has quantified levels of demand for medical

services in Southern England over the seventeenth century, concluding

that an increase of between 400 and 1,000 percent occurred from 1620 to

1690.6 Examining drug imports allow us to extend and contextualize

Mortimer’s analysis: drug imports suggest whether his account of

responses to serious illness extends to a wider variety of conditions; they

show how the trajectory of consumption developed over the century after

his study ends; and they reveal national, rather than regional, patterns. By

examining the types of drugs imported, we can also explore one of the

main explanatory hypotheses Mortimer put forwards for the increase in

consumption that he observed: a shift in the type of medicine used from

Galenic to chemical or Paracelsian medicine.7

The volume and price of imported drugs is, of course, only an

indirect measure of the degree to which the population was utilising a

particular kind of healthcare. Medicine also made much use of home-

grown drugs and other substances, various plants were domesticated in

English physic gardens in this period, substitutes for imported drugs were

available, and medicines were only one part of the art of physic,

alongside diet, exercise and other non-naturals.8 Some practitioners

appear to have used remedies in only a minority of cases.9 Nonetheless,

foreign drugs were an important part of the therapeutic core of much

commercial medicine, particularly in Galenic physic. They were also

central to the retail trade in medical substances; they were the mainstay 5 Pelling and Webster 1979; Pelling 2003, pp.136-224; Wilson 1995, pp. 161-9; Mortimer 2009. 6 Mortimer 2009, pp. 39-40. 7 Mortimer 2009, pp. 65, 90, 207. 8 Stobart 2008, pp. 153-65; Leong 2006, pp. 98-103; Wear 2000, pp. 46-78. 9 Kassell 2005, pp. 154-7.

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of the remedies sold in the shops of apothecaries, druggists, and other

retailers.10 For a medicine established and fostered around the shores of

the Mediterranean, the heartland of the pharmacopoeia inevitably lay far

to the south of England’s shores. If imports of medical drugs were not

arriving in large quantities, then we can reasonably presume that this

form of medicine was not being used widely, and vice versa.

Sources and Method English drug imports and exports are recorded in two main

locations: for the sixteenth and seventeenth centuries, Port Books contain

undifferentiated lists of the cargoes of ships which were noted down as

they entered and left the country; from 1696, overseas trade is

summarised in the annual ledgers of the Inspector-General of the

Customs. These records were kept as part of the process by which

customs’ duties were collected. Because of this, both the Port Books and

the Ledgers have a number of limitations. Goods imported or exported

duty-free were not recorded.11 The estimates of value they contain were

based on dubious prices and calculations. Incorrect entries at the

customs house are also an issue: false entries are a feature of the

system, particularly for geographical information, where monopolies of

colonial trade supplied motives for lying about origins and destinations of

goods.12 More importantly, drugs may have been smuggled to avoid tax,

despite its relatively low rate for the early part of the period.13

Port Books and Ledgers also present particular practical

challenges. First, Port Book survival is geographically patchy. 14

10 Wallis 2002, pp. 194-8. 11 Willan 1962, p. x. 12 Clark 1938, pp. 33-37; Hoon 1937, p. 257; Ashworth 2003, pp.133--64. 13 Ashworth 2003, pp. 165-83. 14 Several Port Books used by Roberts are no longer fit for production.

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Fortunately, survival appears to be best for London, the epicentre of the

drug trade. I take London’s records as a proxy for national import totals

before 1699: extant records for other ports indicate that few drugs entered

elsewhere, and at the end of the seventeenth century, when the Ledgers

allow us to compare London and the outports, almost 95 per cent of drugs

arrived in London. 15 Second, the Port Books are an un-indexed list

written in cramped and variable handwriting. Identifying drugs is therefore

a slow process that is vulnerable to errors: the figures obtained are, as a

result, minimum estimates of the quantities imported.16

Third, Port Books only survive for certain years, or even part years.

Trade by English and foreign (alien) merchants was recorded in separate

volumes, and sometimes only one survives.17 These years may be

unrepresentative, as trade varied with war, economic fluctuations,

blockades, epidemics and fires. Such events undoubtedly affected some

of the years utilized here, for example 1567 was three years after the

disruption caused by the English embargo on foreign shipping (1563-4)

and just before political crisis severely disrupted Dutch trade, while 1617

coincides with the Cockayne project.18

Survival is poor enough that for 1567 to 1640, I use all accessible

surviving Port Books for imports into London. For 1663 and 1669, a set of

15 No drugs were listed among imports in the Liverpool port book for 1665 (The National Archives [hereafter TNA], E190/1337/16); in 1709 the port book (TNA, E190/1375/08) recorded imports of Sarsaparilla of 1,533 lb; exports that year included 19lb of apothecary wares: Power, Lewis and Ascott 1998. 16 Errors and omissions in Roberts’ figures meant they could not be relied on here. For the data before 1699, all individual drug consignments that were substantial enough to affect the total for a year (making up >5% of the annual total by value) were re-checked, as were any imports that differed markedly from the norm (by volume) for that product. The net effect of the data cleaning process is to further bias these figures downwards, as excessively large consignments were checked and corrected when errors were found, but low figures were not. As well as similar tests for errors, the data for 1699-1774 was all manually re-checked against the original Ledgers. 17 Data corrections are summarised in the note to table 1. 18 De Vries and Van der Woude 1997, pp. 363-4; Dietz 1971.

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near-contemporary totals for commodities imported survive.19 For 1670 to

1699 I examined the 1686 Port Book: a year of peace which Nuala

Zahediah had already worked on for the Colonial trade.20 Exports and re-

exports in the sixteenth and seventeenth century are harder to identify.

Fewer Port Books for exports survive, and many only list cloth exports.

Where possible, proximate years are averaged to reduce the impact of

short-term variations. This has been possible for the 1630s, 1660s and

the samples from 1699 onwards. Full details of the Port Books used are

given in Appendix A. Fortunately, for the eighteenth century, the Customs

Ledgers all survive and I use the three-year sample periods that Davis

pioneered: 1699-1701, 1722-1724, 1752-1754 and 1772-1774.21

Compiling figures for medical drug imports also presents

methodological problems. One crucial question is what counts as a

medical drug. The Customs’ Books of Rates which set out the notional

values for goods on which taxes were calculated included a distinct sub-

section of ‘drugs’ from 1604 onwards.22 However, not every item in that

sub-section was used as a medical drug. A number of items were

primarily used for other purposes, whether as dyes and pigments

(verdigris, cerussa, vermillion), perfumes (ambergris, musk, civet, myrrh),

ornament (coral and other precious stones), pleasures (tobacco,

pistachios), cooking ingredients (cumin seed, coriander seed, long

pepper, green ginger) or for various manufacturing or industrial processes

(gum arabic, sticklack, mercury). These items were frequently also used

medicinally, but it seems reasonable to assume that it was not medicine

that determined the scale of demand for them, and that any changes in

consumption of these commodities might well result from quite different

19 See Davis 1954, p. 155-7. I use the totals by volume rather than the valuations Davis discusses. 20 Zahedieh 1994. 21 TNA, CUST 3, 3-4, 24-26, 52-54, 72-74; Davis 1962. 22 Commissioners of Customs 1604, Sig.Cv-D2r.

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imperatives. Moreover, certain new and unusual drugs were not included

in the ‘drug’ section of the book, wormseed for example, and many drugs

were missed out completely and appear in the Port Books with prices

estimated ‘ad valorem’ (at value) on an ad hoc basis.

In order to focus on changes in medical consumption, I sub-divide

imports into two sample groups of commodities. The first is based on the

‘drugs’ section listed in the 1660 Rate Book and the 1725 addendum.23

This ‘Rate Book Drugs’ sample includes the full range of medical and

non-medical items listed there. The second, ‘Medical Drugs’ sample

includes only those substances that were primarily used in medicine. In

its fullest form this includes medical drugs that were not listed in the rate

book but were imported at value, and excludes those commodities which

were heavily used for other purposes. For reasons explained below, the

discussion focuses on those which overlap with the Rate Book. The full

contents of the samples are listed in Appendix B. The most significant

differences between the two samples is the exclusion of dyestuffs,

precious stones, perfumes and spices from the ‘Medical Drugs’ sample.

The selection process is inherently subjective – in particular, scents and

preservatives overlapped in this period - but the trends described below

are robust to changes in the content of the medical drug sample.

Another major problem is measuring the trade in such a highly

varied and extensive set of commodities. Imports are largely recorded by

volume only until 1699. Both price and volume are available for most

imports thereafter. In order to outline long-run trends in drug imports and

consumption, I revalue drugs using constant prices taken from the two

sets of official customs valuations that were used to define the samples

as a rough solution to the problem of aggregating different commodities

over a long period of time. Customs’ prices theoretically reflect the price

23 A Subsidy granted to the King of Tonnage, & Poundage, 1660, pp. 44-56; An Act for Rating Such Unrated Goods, 1725, pp. 156-9.

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of the commodities at first cost in their place of purchase, not the sale

price in London, and these values therefore have only a loose connection

to the nominal wholesale value of imports in any year.24 In practice, drug

valuations appear to have been higher than the wholesale price, thus

increasing the effective rate of tax and inflating the value of imports.25

The availability of customs’ prices is a further constraint. For 207 drugs, I

use official valuations taken from the 1660 rate book; these drugs account

for the bulk of trade.

y

26 However, because the range of medical drugs

being imported expanded in this period, relying on 1660 prices alone

would undervalue imports in the latter part of the period. Many new drugs

were assigned official customs valuations in 1725, and another 67 prices

are taken from this source.27 The effect of their inclusion is shown in table

1; as can be seen, the overall trends in imports are not substantiall

changed until the 1720s, after which they produce a slightly higher growth

rate, as one would expect given the chronology of their entry into the

Book of Rates. There is some under-counting where volumes were not

recorded for drug imports, but the value of these consignments was

generally small.28 The same prices are used here for re-exports and

exports. The majority of the data discussed below should thus be taken

as being in 1660 prices. In addition, for comparison with other series, data

on imports are also presented as valued by customs’ officials on entry for

the period from 1699.

Unfortunately, customs’ valuations were not recorded for all

imported medical drugs. Some drugs were too obscure or too new to be

24 Davis 1954, pp. 157-8; Schumpeter 1960, pp. 1-9.For a good discussion of the difficulties in valuing trade, see: Smith 1995. 25 See table 6. 26 A Subsidy, 1660. 27 An Act, 1725. 28 Including imports without volumes at the nominal value assigned to them by customs on entry would have little effect on the aggregate series. They would contribute more than one percent to a series based on medical drugs with values in the 1660 and 1725 Rate Books on only two occasions: 1609 (2.4%) and 1722-24 (4.2%).

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valued. Fortunately, so far as can be established, this has a limited

impact on the aggregate pattern, and these drugs can be excluded from

the main discussion without substantially altering the overall picture. For

those medical drugs without customs valuations, one can estimate the

effect they would have on the value of the imports in two ways. Fifteen

commodities in the medical drugs sample were imported regularly enough

that a valuation can be constructed using the average of the ‘Ad Valorem’

estimations made by Customs officials in the later three eighteenth

century samples (1722-1774).29 When these values are used, this group

of drugs never exceed four percent of the value of all medical drug

imports in the eighteenth century, or half a percent in the seventeenth

century.30 For another fifty four medical drugs, customs officials only

recorded cash valuations. Although extensive, this group never exceed

one percent of the value of imports over the two centuries.31

These practical and methodological challenges mean that the data

presented should be seen as a set of rough estimates, proxies for a set of

real changes that we cannot now fully recover. Although values are

discussed for convenience, it is the rates of change that are most reliable.

The problems are particularly obvious for the aggregate data on drugs as

a category, but even the figures for individual drugs presented in

Appendix C need to be treated with care.

29 Although notionally actual prices, the Customs’ ad valorum estimations quickly became fixed. 1722-74 was a time of relatively little change in official prices (unlike 1699-1701) and therefore gave a large sample from which to work, despite their greater chronological distance from the 1660 rate book: Clark 1938; Davis 1962, p. 285. 30 In 1699-1701, they would contribute 3.8% to a series based on medical drugs with values in the 1660 and 1725 Rate Books. For 1722-24, 1752-54, and 1772-74, the equivalent figures are 2.6%, 2.4%, 2.5%. 31 See Appendix B for a full list of drugs imported.

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Drug Imports Between the late sixteenth and the late eighteenth centuries,

English drug imports increased substantially. Annual totals for imports are

given in table 1. Both imports of commodities classified as ‘drugs’ in the

rate books and the narrower sample of ‘medical drugs’ increased

massively between 1567 and 1774, rising by around two orders of

magnitude. By the 1770s, medical drug imports were running at around

£100,000 a year, fifty times greater than the £1,000 to £2,000 a year

common two centuries earlier. Drug imports grew much more rapidly

over this period than imports in general, which increased by roughly

twelve times.32

[Insert table 1 near here]

The growth in medical drug imports was concentrated in the

seventeenth century. In the second half of the sixteenth century, the

quantity of drugs imported was small and relatively stable. In the years for

which we have data, 1567, 1588-89, and 1600, the value of imports of

medical drugs ranged around one and two thousand pounds a year.

There was no obvious trend of growth or decline in the volume of trade in

this period, as was the case for English imports in general.

Signs of growth are visible in 1609, and from the 1620s to the

1660s drug imports increased substantially. In 1629, the peak year in our

sample before the 1680s, the volume of imports was £25,774, over ten

times greater than the average for the late sixteenth century. The figures

for 1617-24, 1633 and 1638 suggest a slightly more modest level of

imports was normal, but even they were consistently five times higher

than the earlier norm. Such annual variations are unsurprising for trade.

The data for the 1660s, although based on summary figures, suggest that 32 Imports were c. £1 million in 1600, and £13 million in 1772-74: Davis 1962, p.300.

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trade in drugs had expanded further. Imports in 1662-8 were higher than

had been normal in the 1620s and 1630s (although not dissimilar to

1629). In the later seventeenth century there was a further substantial

increase in the volume of medical drugs imported. Although by no means

smooth, the rate of growth was high across the seventeenth century as a

whole. The level of imports in 1699-1701 was 27 times higher than a

century earlier.33

Over the eighteenth century, the volume of medical drugs imported

grew much more slowly. Imports actually fell between 1700 and 1723.

They rose again by the 1750s, before apparently stagnating at around

twice the level at the start of the century. Even with three year averages,

this oscillation is not surprising given the effect that relatively small

volumes of highly priced drugs could have on the totals. Over the century,

the growth in medical drugs was much lower than the 217 per cent

increase in the level of English imports in general.34 Imports of the wider

customs category of ‘Rate Book Drugs’ grew at roughly the same rate,

with an expansion in the importation of black lead, borax, sandalwood,

and turpentine in particular. In 1772-74, these non-medical ‘drugs’ made

up four of the five ‘drugs’ imported in largest quantities. Rhubarb was the

only ‘medical’ drug among the five most significant drug imports by value,

at fifth place.

[insert table 2 near here]

The use of constant prices to aggregate imports makes it important

to consider whether the pattern of imports could be an artefact of the

price level in 1660. We can explore this in several ways, and their effect

33 Calculated using the averages given in table 4. Growth rates were fastest in the first part of the century: 866% for c.1600-c. 1630 compared to 177% from 1665 to c.1700. 34 Growth calculated from nominal values: Davis 1962, p. 300.

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on the level of imports is summarized in table 2. For the eighteenth

century, we can measure imports using the nominal value of imports as

assessed and recorded by customs officials on entry. These were, in

practice, a roughly constant set of official prices from the early eighteenth

century (the totals are in table 1, columns 3 and 6). The trajectory of

imports over the eighteenth century does look somewhat more optimistic

on this measure and the dip from 1700 to 1720 disappears. However, the

change in the overall value of imports was little different: the ratio of

imports in 1772-74 compared to 1699-1701 was 2.3, compared to 1.8

when estimated at 1660 prices. Note that when imports are totalled using

nominal values they are worth only around half the amount when valued

at the 1660 prices, indicating a substantial fall in the price that the

customs’ officers applied to these drugs. We can also compare trends

over the full period using official prices from earlier and later in our period.

For most frequently imported drugs, we can use the average valuations

from the later three eighteenth century samples (1722-1774).35 As can be

seen in table 2, the levels of growth observed in the eighteenth century

with these prices are very similar to those found with 1660 prices. The

faster rate of growth in the seventeenth century reflects the narrower

sample of imports: if we calculate growth rates using 1660 prices for the

same sub-sample of medical drugs the ratios are very similar.36 To see

the effect on imports of using earlier prices, we can use official prices

from the 1604 Rate Book. In this case, as table 2 shows, the levels of

import growth were little different from those found using 1660 prices. Our

account of growing drug imports therefore appears to be robust to

changes in the price level. This exercise further suggests that growth of

imports was not biased towards those drugs that were becoming

35 See n. 29 for an explanation of the methodology. 36 When the medical sample at 1660 prices is restricted to those drugs which appear in the sample with Ad Valorem prices the ratio of imports in 1600:1700 is 60.7, and 1630:1700 is 110.9.

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relatively cheaper: if that were the case, we would expect lower estimates

of import growth when using eighteenth century prices. Either the fall in

price over this period appears to have affected drugs more or less

indiscriminately, or demand was relatively unresponsive to price.

On their own, however, import figures are a limited guide to English

medical consumption. The crucial issue for our understanding of the drug

trade’s effect on consumption is the value of re-exports. It was in these

centuries that England emerged as an international entrepôt, and many of

the drugs and other commodities imported were simply passing through

on their way to other destinations.

Re-export levels are obscure before 1700. Nonetheless, some

figures can be constructed for a few select years. For the period before

1640, only four surviving Port Books offer a reasonable picture of re-

exports and exports.37 We have no good basis on which to estimate the

proportion of trade by English and Alien merchants, so must rely on

combining proximate years. Although re-exported imports are not

differentiated from English produce in the Port Books, it is possible to

identify drugs that were not grown or produced domestically; of course,

England could and did import drugs that were also grown there, such as

wormseed and saffron. In table 3 these crude estimates for re-exports are

compared to the imports discussed above.

[insert table 3 near here]

Around 1600, England seems to have retained only a small share

of the medical drugs it imported. Re-exports were worth two thousand six

hundred pounds: substantially more than the value of medical drugs

imported around 1600, and almost two-thirds of the value of imports in

37 An earlier port book for 1576 survives, but it is unclear whether this covers all or some merchants.

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1609. Even in the wider Rate Book drugs sample, imports and re-exports

roughly balanced. The export Port Book for 1599 records English

merchants alone exporting a greater value of medical drugs than would

arrive in 1600, largely due to the re-export of large quantities of

Sarsaparilla (£1,700) and Benjamin (£483). By the 1630s, re-exports

amounted to only around a fifth of the value of drug imports with a much

larger share of imports retained for English consumption. The margin of

error in these estimates is large given the wide annual variations and

unmatched sample years, and the figure for retained imports in the 1630s

is probably an over-estimate. Nonetheless, it seems reasonable to

conclude that the rate of growth in English drug consumption in these

decades may have been even higher than suggested by the import data

alone.

From 1640 to 1699 no useful information about re-exports survives.

From 1699 onwards, however, the Customs records include extensive

data on both exports and re-exports. These remain high. As can be seen

in table 3, around half of drug imports were re-exported. However, as the

total size of the drug trade had grown substantially, the volume of medical

drugs retained for consumption was now much larger. By the start of the

eighteenth century, domestic consumption was more than twice the level

in the 1630s. Tellingly, given that retained imports around 1600 could not

exceed the total of imports, these figures imply that by 1700 the level of

English medical drug consumption was at least fifteen times higher than a

century earlier.

After 1700, medical drug consumption followed a very different

trajectory. From 1699 to 1774, the volume of medical drugs retained

appears to have grown slowly, with a decline in the 1720s. The wider rate

book drug sample continued to grow rapidly, reflecting the demand for

minerals and dyes in England’s expanding manufacturing sector. While

imports doubled, the volume of foreign medical drugs retained for

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consumption in England was only around forty percent higher in the

1770s than in 1700. The crucial transformation in demand occurred in the

seventeenth not the eighteenth centuries.

These figures are based on official records. Some of the

moderation in growth over the eighteenth century may be in part

explained by the striking increase in customs duties in this period. Initially

taxed at five per cent of a fixed, notional value, customs duties increased

substantially from the late seventeenth century onwards. By the mid-

eighteenth century, duties had increased to 20-25 per cent on many

drugs.38 Given drugs’ low bulk and high value, they were an obvious

target for smuggling; this would be less of a problem for the bulkier and

lower value items in the wider rate book drug sample. The Parliamentary

Committee set up in the 1780s to examine frauds against the revenue

reported that ‘a considerable proportion of the Drugs imported from the

East Indies and from China is exported to the Continent of Europe for the

drawback, in order to be afterwards re-landed clandestinely in this

kingdom, together with what can be smuggled also from the Danes,

Swedes and Dutch’.39 Consumption may have risen in the eighteenth

century but been concealed from the official record. However, it is unlikely

that smuggling could obscure a level of growth of the order of magnitude

observable in the seventeenth century. Even if half of the drugs

consumed in the eighteenth century were smuggled, this would suggest

only just over a doubling of consumption – small beer compared to the

explosive fifteen-fold growth in the century before.40

38 Duties on drugs were complicated. Moreover, as the Ad Valorem estimates from the eighteenth century were generally lower than the earlier Book of Rates valuations the effective rates of taxation may in fact have fallen. For rates and calculations see: Saxby 1757; Baldwin 1770. See also: Davis 1966, pp. 307-11; Ormrod 2003. 39 House of Commons, 1782-1802, XI, p. 291. 40 Smuggled tea may have accounted for three times the volume of legal imports, but even if drugs were smuggled at that rate the argument still holds: Ashworth 2003, pp. 176-8.

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While foreign imports and re-exports are the most visible part of

this story, exports cannot be neglected entirely. Export figures for medical

drugs are hard to establish for much of the period and, as far as we can

tell, England’s ability to produce raw drugs of interest to the international

market was limited. Unprocessed drug exports centred on a small cluster

of raw or partially processed materials with a wide range of applications,

primarily quicksilver, white and red lead. While having medical

applications at the time, these mainly served non-medical purposes. From

the later seventeenth century onwards we can, however, identify a rise in

English exports of processed medicines. These are normally listed in the

customs records as ‘apothecary’s wares’. From other sources we know

that proprietary medicines could be entered under that heading, but it is

likely that traditional compound medicines and processed simples (non-

compounded medicines) were also included.41 In the 1686 Port Book, a

few entries are described as ‘medicines’, ‘spirits of scurvy grass, or

compound waters’, while in the 1699-1701 Customs Ledgers, ‘plague

water’, Daffy’s Elixir, Epsom salt and spirits of scurvy grass, are recorded.

Later in the eighteenth century, this level of detail unfortunately

disappears. It is difficult to value this trade. In 1663/9, an average of

16,330 lb of apothecary’s wares were exported. By 1699-1701 this

amount had risen to 70,815 lb (around £1,300 at official prices). The

valuation used by the Customs’ officers was £2 per hundredweight, but

this is far below the wholesale price. For a few items exported by Anthony

Daffy, the manufacturer of Daffy’s Elixir, we can compare the customs’

valuation with the actual wholesale price. Notionally, Daffy should have

paid a 5 percent tariff. In practice, he paid between 1 and 1.6 per cent,

suggesting the degree of undervaluing at the docks. 42 By the late

41 Haycock and Wallis 2005, pp. 24-25. 42 TNA, E 190/72/1. On 11 July 1677 three consignments of apothecary wares from Daffy are noted (under the name of William Ball, who acted for him in the port): one, for 120 bottles that Daffy priced at £15 was taxed at 4s; the other two Daffy had valued at

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eighteenth century, exports of apothecary’s wares had grown

dramatically. In the 1770s, an average of over 1,300,000 lb. (£23,259 at

official prices) was being exported – almost twenty times the amount at

the start of the century. Export-oriented drug production had become a

reasonably-sized industry in England: by way of comparison, in 1772-74

grain exports were valued at £37,000, hat exports at £110,000, and

cottons at £221,000.43

Total values for drug imports only tell us so much. The kinds of

drugs imported suggest more about London’s role in this trade and the

characteristics of medical supply and demand more generally. Given

London’s high re-export rates, and the impossibility of chronologically

matching imports and exports before 1699, we cannot assume that this

represents changes in English demand. However, it should give some

indication of changes in consumption across Europe and its colonial

dependencies, given London’s role in funnelling commodities into these

markets.

One of the obvious features of the medical drug trade was the very

wide range of commodities imported. The number of different types of

medical drugs imported each year ranges from lows of 4 in 1604 and 11

in 1600 to highs of 142 in 1686 and 174 in 1699-1701. The average

number of different kinds of drugs rose over the period from 29 in the late

sixteenth century, to 66 between 1620 and 1640, and a remarkable 143

types between 1699 and 1774. Only 15 of the 230 items listed in the drug

section of the 1604 Rate Book were not recorded as being imported at

£28 10s and £30 and both were taxed at 8s (f. 158r). On 17 Sept 1677, one shipment of ‘Apothecarys wares’ taxed at 4s.which had been priced at £19/10/00 by Daffy (f. 218r). On 2 November 1677, one shipment of ‘Apothecarys wares’ taxed at 8 s. which had been priced at £24 by Daffy (fol. 265v): Haycock and Wallis 2005, pp. 44, 137, 151. 43 Davis 1962, p. 302.

17

some point in the period.44 In addition to these figures for the number of

types of drugs imported in reasonable bulk, we must allow for the

importation of smaller quantities of drugs that were not listed individually.

The diversity of the early modern published pharmacopoeias was, it

seems, reflected in the variety of drugs available.

While consumers’ demand for a wide range of medicinal

substances was met to some degree, a much smaller group of drugs

made up the majority of imports. Table 4 lists the ten leading ‘medical

drugs’ (measured at official values) in each period. Even though the

variety of drugs increased over this period, in every period apart from

1699-1701 this small sub-set made up around two-thirds to three quarters

of all drugs imported. Indeed, the five most common drugs regularly

constituted around half of imports by value.

[insert table 4 near here]

The leading medical drugs imported changed substantially over the

period. However, a core of drugs were prominent throughout. Senna

featured among the most popular in all periods, and China Roots,

Benjamin, Rhubarb and Sarsaparilla were present in all but one or two

periods, indeed, rhubarb headed the list three times. All were medical

staples of well-known efficacy.45 Among the other drugs imported in large

amounts in the late sixteenth century and early seventeenth centuries,

wormseed remained a common import (see Appendix C). The other major

drugs (spica celtica, sanguis draconis, agaric, and ireos) in the early

period fell away dramatically in importance. This is probably a product of 44 These are: Anacardium; Blatta Bizantiae; Cytrauge; Daucus; Generall; Mirabilanes condited; ol Scorpions; Ossa de Corde cervi; Sal alkali; Sandiver; Soldonella; Terra lemnia; Thlaspi semen; Turbith Thapsiae 45 Grieve suggests that China Root is a synonym for Galangal (Grieve 1931, p. 339), but they were regarded as distinct drugs in the seventeenth century (see: Commissioners of the Customs 1604; Pechey 1694, p. 232).

18

the low level of trade in the early period making the ranking process

rather more volatile than later on. For the only manufactured drug on the

list, the plague and poison remedy theriac, which also fell out of the list of

leading imports quickly, import substitution was also a real possibility, as

was the effect of the decreasing frequency of plagues. The changes in the kinds of drugs imported into England were thus

largely additive. It would be the easy availability of medicines in 1800, not

the types of drugs imported, that would have most surprised a physician

from two centuries earlier. Four-fifths of the leading drugs imported

between 1567 and 1774 were sufficiently familiar that they were listed in

the first Pharmacopoeia Londinensis published by the College of

Physicians in 1618.46 The most significant change in the types of drugs

imported over this period was a product of the development of trade

routes, not the result of a shift in medical theory or practice.

The changes in the reported origins of England’s drug imports are

shown in figure 1. English customs’ records only provide the port at which

a cargo was embarked for its final passage to England, so this data does

not fully capture the shift in the origins of drug imports. Thus, Asian drugs

imported by the Dutch East India Company would be recorded as

originating in the Netherlands, while early imports from India or the Levant

might be recorded as Italian or Flemish. This is less important where

drugs originated from England’s American and Caribbean colonies, as

they were generally imported directly. Drugs from South and Central

America, however, would often be transhipped and so appear as

‘European’. A further minor complication is that ports of origin were not

always recorded or discernable in the original Port Books of the

seventeenth century.

46 Of 30 ‘leading drugs’ in table 4, 24 were listed (two others were waters): College of Physicians 1618.

19

Even with these limitations, some of the major changes in the

structure of the English drug trade are clear in figure 1. Two new sources

of imports emerged, both helping to displace the Northern European axis

of Flanders and the Netherlands that had previously dominated English

trade. First, from the early seventeenth century onwards, Asian

commodities were reaching England directly, in the ships of the East India

Company. Large-scale commerce in rhubarb, opium, and olibanum

(frankincense) in particular was one of the major changes in the English

drug trade. Second, from small beginnings in the late seventeenth

century, the Americas became an important source of drugs from the

1720s onwards. The majority of these drugs, such as guaiacum,

sarsaparilla and Jesuits’ Bark, came from Central and South America;

fewer came from the English colonies in North America, although there

were a handful of exceptions such as Virginia Snakeroot and Pink root.

Among American drugs, one stands out for its exceptional importance:

Jesuits Bark, which made up 40 per cent of all direct American drug

imports into England over the whole period. Perhaps less expected is the

emergence of a substantial trade in mineral waters, both generic ‘spa

water’ and Pyrmont water, notionally from the Westphalian spa town.

What implications did this shift in the availability of foreign

medicines have for patients in early modern England? It is difficult to

move from aggregate imports to the sick-bed. Medical practices were

diverse and there were multiple uses and modes of processing and

preparing for drugs. However, some crude impression of the impact of

rising drug imports on their availability to the population at large can be

obtained from translating imports into courses of treatment. Table 5 uses

standard pharmacopeia and medical texts to estimate the number of

‘treatments’ of five of the most common imported drugs. I consciously use

‘treatment’ loosely here. The amounts prescribed for different illnesses

varied. Some drugs, such as sarsaparilla, were primarily used in

20

compound form, and it is rarely clear if an author was describing the

volume necessary for a cure, for one among a series of doses, or for the

production of a medicine that would treat multiple cases. As far as

possible, the low and high estimates presented here are the volumes that

authors indicated as necessary to treat a case. Even so, achieving a

purge with senna or rhubarb is a relatively precise goal compared to

treating syphilis with sarsaparilla. Conversely, someone might use purges

regularly, whereas they were more likely to use Jesuits bark or

sarsaparilla sporadically as occasional illnesses demanded. These

estimates are based on the retained imports of these drugs, assuming

half are re-exported: re-exports for individual drugs fluctuate wildly even

in the eighteenth century.47

[insert table 5 near here]

While the figures in table 5 are speculative at best, they do suggest

that the increase in the consumption of medicine over this period must

have extended far beyond the elite. In the late sixteenth century, even the

most common imported drugs, such as senna, were still only arriving in

sufficient volume to treat a few thousand people. Only wormseed (on a

low dose) offered the possibility of mass consumption in the first half of

the seventeenth century and an indigenous production and export trade

appears to have emerged for wormseed. Prescriptions, inventories,

household accounts and institutional records show that some imported

drugs were being consumed in England during the sixteenth century.

However, the vast majority of English demand for medicines must have

been met by remedies using domestically produced drugs. By the mid-

47 Even with three year averages, when imports and re-exports are compared for specific drugs we find that re-exports can exceed imports. In this sample, this occurs with rhubarb (1770s), wormseed (1740s, 1770s), and sarsaparilla (1720s).

21

seventeenth century, this had changed dramatically: already by the

1660s, senna imports might equate to between thirty thousand and three-

quarters of a million purges for a population of around 5.2 million. A

century later, an average of almost one (low) dose of senna per every two

people was imported into England. The figures for rhubarb and

sarsaparilla give similar impressions. Similarly, it is surely indicative of a

mass market for Jesuits’ Bark that the amount imported in the 1720s and

1750s could have provided between two hundred thousand and a million

treatments.

While this evidence of dosages imported indicates the appearance

of a mass market for medicines, the ability of the sick to utilize different

medical treatments, and the impact of their decision to consume, is a

function of price as well as availability. Evidence on the prices of drugs is

even scarcer than evidence on levels of imports. However, for the 1660s

to the 1730s and for a few years in the 1790s some bulk wholesale prices

for drugs sold in the London market are available from surviving Price

Courants, essentially price newspapers for merchants.48 Prices for nine

prominent drugs are presented in table 6. The prices have been deflated

using Allen’s Consumer Price Index for London, which contains a basket

of food based on a labourers’ diet, with 1666-75 taken as the base year.49

Inflation has little effect until the 1790s.

Despite capturing the last period of rapid expansion in drug imports

in the later seventeenth century, there is no clear trend in drug prices

between the 1660s and 1700. The prices of Benjamin, Senna, Opium,

Scammony were remarkably stable. Wormseed and rhubarb increased in

price, the latter by more than 100 percent. The prices of Aloes Socotrina

and Sarsaparilla did both fall by roughly a third, but Jesuits Bark was the

only drug to see a very large fall in price (although its initial high price is

48 Price 1954, pp. 240-9. 49 Allen 2001.

22

based on a single price report) of the kind that might be expected when

the quantity imported grows so quickly. By the end of the eighteenth

century, the real price had fallen for five drugs: Aloes Socotrina,

Benjamin, Jesuits Bark, Opium, Sarsaparilla. However, Rhubarb and

Senna cost around the same as in the 1660s, while Scammony was twice

as expensive and Wormseed was no longer listed. An un-weighted

average of the relative change of the drug prices in table 6 suggests that

prices in the 1790s were on average 15 percent lower than in the 1660s:

a small change when medical drug imports were ten times higher.

Unfortunately, the Price Courant price data only begins after the

most dramatic growth in drug imports had ended. Figures from earlier in

the century suggest that prices for some drugs may have fallen

significantly by the 1660s. In the early 1630s, the wholesale price for

Senna (42d/lb), rhubarb (253d/lb), Benjamin (80d/lb), Opium (160d/lb)

and Sarsaparilla (80d/lb) were all markedly higher than later in the

century.50 For these five drugs, prices fell on average by around 50

percent between the 1630s and 1660s. As these are wholesale druggists’

prices, not port prices, they may overstate the decline, but it seems likely

that the initial expansion in drug imports was accompanied by substantial

price falls.

Conclusion Taken together, the shifts in price and imports show the key

characteristics of the evolution of the English medical drug trade over this

period. In particular, the seventeenth century seems to have been the

period of greatest expansion in supply. While drug prices fell initially, it

50 Prices: Henry Box, [Account Book], Yale University, Beineke Library, Osborn b211 (average, 1629-33); Anonymous Apothecaries’ Stock Lists, Wellcome Library MS 7646. Senna, (n=24), Rhubarb (n=11), Opium (n=2), Sarsaparilla (n=13), Benjamin (n = 4).

23

seems that the demand for medicines outstripped supply over the last half

of the seventeenth century, keeping prices buoyant despite increasing

volumes. Large scale domestic consumption of imported drugs was firmly

established by the start of the eighteenth century: the use of imported

medicines cannot have been restricted to the elite by that point. The next

century saw far less change in overall levels of consumption. Individual

medicines, such as Jesuits bark, boomed, but more generally both prices

and retained imports grew slowly. As the persistent growth in the levels of

imports and re-exports underlines, England’s involvement in the

international drug trade continued to expand rapidly; but this was driven

by foreign, not domestic, demand. Over the period, medicinal drugs

showed little signs of the relative decline experienced by for the fine

spices, or the ‘demystification’ recently suggested by Halikowski Smith.51

This chronology of rising medical consumption puts medical drugs among

the earliest group of exotic imports to boom: for most other groceries,

Shammas identifies the major rise as occurring in the eighteenth century;

only tobacco was available in sufficient quantities for mass consumption

in the later seventeenth century.52 Evidence of a dramatic expansion in drug imports into England

provides us with a new perspective on changes in the consumption of

healthcare in this period. To the extent that drug consumption offers a

rough indicator for wider shifts in demand for medical services, it seems

that the turning point in English consumption came in the early decades

of the seventeenth century, and the period of greatest growth had ended

by 1700. As figure 2 shows, the timing and scale of the change in drug

imports closely parallel Mortimer’s data on the increasing resort to

medical practitioners in Southern England, suggesting that this reflects a

national trend, and indicate that his data fortuitously capture the main

51 Halikowski Smith 2008, pp. 416-9. 52 Shammas 1990, p. 77-82. See also: Wallis 2008, pp. 45-9.

24

transition in consumption. The trajectory of prices sketched out above

adds weight to this interpretation, as the rising levels of demand Mortimer

found would have helped prevent prices from falling as imports expanded.

This chronology also matches the main institutional changes in regulation,

notably the establishment of the Society of Apothecaries in 1617 with its

aspiration to monopolize the sector, the appearance of bulk contracting

for drug supplies for the navy and East India Company, and the mass

production of proprietary remedies. 53

That drug imports and payments for medical goods and services

grew in parallel offers another way to interpret the expansion in medical

consumption in this period. Mortimer emphasizes improvements in the

productivity of medical practitioners, achieved particularly through their

easier access to the sick, in his explanation for how the supply of

healthcare could keep up with the growth in demand.54 He also highlights

a turn to chemical medicines. However, while the supply of chemical

medicines cannot be usefully observed through the Customs’ records,

given the range of industrial uses of their raw materials, the ongoing

popularity of Galenic simples provides little evidence of a change in the

content of medicine that might be responsible for shifts in consumption.55

More significantly, the increasing supply of drugs suggests that much of

the increase in expenditure in Probate Accounts may have been due to

purchases of medicines rather than services.56 Economies of scale are

easier to achieve in pharmacy than direct medical or surgical assistance,

allowing us to assume more moderate increases in the workload of

medical practitioners.

53 Wallis 2002, pp. 217-21. 54 Mortimer 2009, pp. 204-5. 55 Mortimer 2009, p. 65. 56 Probate Accounts are too terse for this distinction to be made in most cases, and as Mortimer emphasizes the provision of ‘physic’ was the most common service: Mortimer 2009, p.73.

25

The kinds of medical drugs imported also changed over this period.

However, the changes were mainly an expansion in the pharmacopoeia,

rather than a displacement of older medicines by new drugs. There were

some significant additions. Notably, in Jesuits’ Bark we observe a change

that probably increased the objective efficacy of medicine in treating

some kinds of disease. But the therapeutic range was marked more by

continuity than change. A shift in scale of this kind must, though, have

had wide implications. In rapidly becoming widely available in quantities

that were radically different to earlier periods, drugs, like other new

consumer goods, presented new consumption possibilities and allowed

new sensibilities and modes of behaviour to develop. Imported drugs

linked domestic and commercial medical practice to extensive supply

networks and commercial retailers such as apothecaries and druggists.

They separated the materials of medicine from the direct encounters and

personal knowledge of farm and field. In use, they intertwined foreign

materials with foreign knowledge, increasing the utility of medical

practitioners’ specialized knowledge. The increasing availability of

medicines, old and new, perhaps offers a way to understand why the sick

might look to the market rather than to kitchen physic for their health. The

emergence of mass drug consumption marked a revolutionary shift in the

form, practice and implications of healthcare.

26

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30

Table 1: Drug Imports, 1567-1774

Rate Book 'Drugs' Medical Drugs

1660 & 1725 prices

£

Percentage using 1725

prices

Nominal value at

entry

1660 & 1725 prices

Percentage using 1725

prices

Nominal value at entry

£ £ £ £ £ £ 1567 2,412 0 1,807 0 1588-89 2,291 0 1,385 0 1600 2,412 0 796 0 1609 5,813 0 3,929 0 1617-24 12,858 0 8,002 0 1629 38,578 0 25,774 0 1633 28,326 0 17,734 0 1638 33,815 0 18,678 0 1662-8 78,304 0 31,346 0 1685 94,243 1 48,496 2 1699-1701 115,212 4 51,042 55,383 7 24,2151722-24 121,227 27 64,906 50,695 20 28,4571752-54 220,718 10 159,370 96,112 16 58,4411772-74 233,134 9 174,452 97,089 14 55,093

Notes: Imports are valued in sterling using the Price series described in the text. Where Port Books survive for only English or Denizen merchants, annual totals are inflated by the proportions of all trade in the hands of each group. Trade figures are derived from Millard 1956. The multipliers are: 1567, 1.57; 1600, 4.34; 1609, 2.70; 1617, 3.03; 1621, 1.27; 1624, 6.25; 1629, 1.16. In practice, drug imports did not always parallel the share of all trade: in 1633 Aliens imported 12.9% of all commodities rated in the drug section as against 11% of all imports, while in 1637 they imported 3.8% of drugs against 12% of all imports. For two years, only partial years survive: For 1589, only six months survive and the total was thus doubled; for 1633, only 11 months of the Denizen Book survives and the total was inflated by 1.09. Several years are combined to provide better estimates. For 1588-89, where proximate years for English and Denizen merchants were available, they were summed to produce an annual total. For 1617-24, the Alien Books for 1617 and 1624 were averaged and summed with the English Book 1624. For 1662-8, an average of the two sets of summary totals is given. For 1699 onwards, three year averages are given.

31

Table 2: Ratios of Medical Drug Imports Using Different Price Series

1660 official prices

Nominal values

1722-74 Ad Val prices

1604 official prices

1600:1700 27.2 63.2 31.8 1630:1700 2.7 78.7 2.7 1700:1770 1.8 2.3 2.0 1.8 1720:1750 1.9 2.1 1.9 1.7

Source: as described in the text. Table 3: English Re-exports and Consumption of Imported Drugs

Rate Book 'drugs' Medical Drugs Imports Re-Exports Retained Imports Re-Exports Retained £ £ £ £ £ £ c.1600 3,505 3,053 452 2,037 2,633 -596c.1630 28,646 5,916 22,731 17,644 3,060 14,584 1699-1701 115,212 67,600 47,611 55,383 23,169 32,2141722-24 121,227 42,022 79,205 50,695 30,812 19,8831752-54 220,718 94,981 125,737 96,112 51,272 44,8411772-74 233,134 74,987 158,148 97,089 51,600 45,489

Note: Re-export figures for the 1600s are based on the 1599 Denizen and 1605 Alien Port Books; figures for the 1630s are based on the 1632 Alien and 1639 Denizen Port Books. Import figures for c. 1600 are an average of 1588, 1600 and 1609, and for c. 1630 are an average of 1629, 1633 and 1638. The figure for Retained Imports is calculated from Imports less Re-Exports. Negative figures imply an imbalance of trade between sample years. For 1600 and 1630 Exports were assumed to be re-Exports if the commodity was not produced in England. From 1699 onwards, re-exports are separately recorded in the Customs Ledgers.

32

Table 4: Major Imports, Ranked by Value

1566-1610

1617-38

1662-68

1685 1699-1701

1722-24

1752-54

1772-74

Theriac 1 Sarsaparilla 2 6 6 10 3 2Wormseed 3 1 5 9 6 China Roots 4 7 8 3 1 2 10Senna 5 5 7 5 7 4 7 5Spica Celtica 6 Benjamin 7 2 3 5 4 4Cassia Fistula 8 Sanguis Draconis 9 Agaric 10 Opium 2 6 Rhubarb 3 3 1 9 6 1 1Scammony 4 9 7 9 Spikenard 8 10 Ireos 9 Gum Tragacanth 10 Aloes Cicotrina 1 2 2 10 Ambergrease 4 Manna 4 7 6 8Aloes Epatica 8 3 9Storex Calida 10 Bezoar Stone (of the East Indies)

4

Oyl Anniseed 5 Lignum Vite 8 5 6Jesuits Bark 1 2 7Sassafras Roots 8 Jalap 8Camphor, Unrefined 9Sulphur Vivum 3Pyrmont Water 10Top 10 as proportion of all imports

0.79 0.81 0.83 0.68 0.61 0.76 0.77 0.72

Top 5 as proportion of all imports

0.65 0.70 0.57 0.51 0.40 0.59 0.60 0.49

33

Table 5: Retained Imports as Dosage, Thousand Doses.

Senna Rhubarb Wormseed Sarsaparilla Jesuits’ Bark Higha Lowb Highc Lowd Highe Lowf Highg Lowh Highi Lowj

3 oz 1 dr 2 dr 1 sc 2 oz 0.5 dr 4 oz 2 oz 2 oz 4 dr 1567 2 42 0.5 3 2 76 1589 0.5 12 0.1 0.6 0.8 27 0.2 0.4 1617-241 10 244 35 209 39 1247 3 6 1630-381 8 190 49 292 42 1356 5 10 1662-68 32 757 77 461 46 1,482 2 4 1685 51 1,213 215 1,289 21 669 25 50 8 331699-1701 42 1,002 50 298 53 1,696 17 33 6 251722-24 70 1,676 55 330 20 646 2 4 228 9131752-54 61 1,475 582 3,493 0 0 75 149 296 1,1861772-74 120 2,880 304 1,823 1 41 110 219 112 449

Notes: Retained imports are based on imports less 50 percent to allow for re-exports: this was the average proportion of drugs re-exported 1699-1774. 1. Figures for 1617-24 are an average of 1617 and 1624, and those for 1630-1638 are an average of 1630, 1633 and 1638 Dosages are from: a. Dube 1704, p. 11; b. Pechey 1694, p. 328; Quincy 1782, p. 163; c. Pechey 1694 p. 320, and Wilson 1709, p. 224; d. Quincy 1782, p. 168; e. Quincy 1782, p. 610; f. Dube 1704, p. 130; g. Wilson 1709, p. 294; h. Pechey 1694, p. 394; i. Wilson 1709, pp. 231-2; j. Dube 1704, p. 238; Monro 1781, p. 664.

34

Table 6: Drug Prices: Official Import Rates and Wholesale Prices

Customs Official Prices Wholesale Drug Prices in London

Rate Book1660

Ad Valorem 1722-74

1666-75 1676-85

1696-1706 1731-35 1796-99

d/lb d/lb d/lb d/lb d/lb d/lb d/lbAloes Socotrina 60 5.3 30.8 24.3 17.3 34.1 24.0 (23) (17) (29) (1) (7)Benjamin 40 6 34.1 30.2 33.3 48.7 17.5 (48) (25) (19) (1) (7)Jesuits bark 30 31.4 - 128.5 60.8 61.4 26.5 (1) (26) (3) (38)Opium 80 31.4 34.1 30.2 33.3 48.7 17.5 (25) (18) (29) (30) (26)Rhubarb 240 146 79.7 200.6 187.0 257.4 81.7 (23) (24) (25) (30) (19)Sarsaparilla 40 12 33.6 25.6 20.3 39.9 23.4 (24) (18) (28) (30) (10)Scammony 160 54 110.3 126.7 122.7 163.6 240.0 (24) (31) (54) (2) (26)Senna 30 20 32.3 19.5 31.4 34.1 35.1 (51) (43) (66) (1) (10)Wormseed 40 42 30.8 44.5 50.5 54.2 (33) (36) (46) (14) (0)CPI 1.00 1.03 1.01 0.93 1.58

Note: Number of observations given in parentheses below mean of price for each period. Prices are relative to 1660 levels using Allen’s CPI series reported in the last row. Nominal prices can be obtained by multiplying the price by the CPI. The Ad Valorem price is the average valuation made by Customs in the three sample periods from 1722-24, 1752-54 and 1772-74. Sources and periods: Prix Courrant des Marchandises a Londres (1671-3); Prises of Merchandise in London (1672-4); The Merchants Remembrancer (1680-1); Le Memorial Des Marchands, Whiston (1681-5); Prices of Merchandise in London (1683); Prix Courrant des Merchandises a Londres (1668-1684); The Prices of Merchandise in London (1667-1696); Whiston's Merchants Weekly Remembrancer (1691-1707); General Remark or Miscellanies (1708); Prix Courant de Marchandises A Londres, Mahieu (1699-1715); Weekly Journal or British Gazetteer (1716); Proctor's price-courant (1696-1731); Gentleman's Monthly Intelligencer (1731-1735); Price Current Boston (1784); Price Current of Goods Imported from North America (1798); Price Current of Leghorn (1798-9); Price Current of Goods Exported/Imported (1781-1799); Prince's London Price Current (1796-1799).

35

Figure 1: Origins of Drug Imports, by Region

Note: 'Other' includes drugs from Africa, Northern Europe and the British Isles

Figure 2: Drug Imports to England and Demand for Medical Services

Note: Data corrections given in table 1. Percentage of Probate Accounts of status groups A & B purchasing medical and nursing services in East Kent: Mortimer, ‘Medical Assistance’, ii, p. 23.

36

Appendix A: List of Customs Sources, 1567-1699.

a. Imports

Year Period Reference Merchants 1567-8 30 Sept 1567-24 Sept 1568 E. 190/4/2 (Dietz, 1971) Denizen 1588-9 30 Sept 1588 - 6 April

1588; Apr 1588 - 28 Sept 1589

E190/7/8; E190/8/1 Denizen

1589 4 Apr 1589 –25 Sept 1589 E190/8/2 Alien 1599-1600 1 Oct 1599- 27 Sept 1600 E190/11/1 (also E190/11/3) Alien 1609 29 Dec 1608- 24 Dec 1609 E190/14/5 Alien 1617 30 Dec 1616-24 Dec 1617. E190/21/4 Alien 1621 29 Dec 1620-24 Dec 1621 E190/24/4 Denizen 1624 1 Dec 1623-24 Dec 1624 E190/27/1 Alien 1630 24 Dec 1629-24 Dec1630 E190/34/2 Denizen 1633 29 Dec 1632-24 Dec 1633 E190/37/8 Alien 1633 29 Dec 1632-27 Nov 1633 E190/38/1 Denizen 1638 24 Dec 1637-24 Dec1638 E190/41/1 Alien 1638 24 Dec 1637-24 Dec1638 E190/41/5* Denizen 1662-63 Michaelmas 1662 to

Michaelmas 1663 CO 388/2, f.7 All

1668-69 Michaelmas 1668 to Michaelmas 1669

CO 388/2, f.13 All

1686 24 Dec 1637-24 Dec 1638 E190/143/1 Denizen 1686 24 Dec 1637-24 Dec 1638 E190/137/2 Alien

NB: I excluded 1574-5 as it contains no ‘medical’ items, and 1604 which only covers 3 winter months. * Significant parts (c.10 per cent) of this book are damaged and illegible

b. Exports

Year Period Reference Merchants 1576 Easter - Michaelmas 1576 E190/6/4 All 1598-99 Michaelmas 1598-

Michaelmas 1599 E190/10/11 Denizens

1605 4 Jan 1604/5- 23 Dec 1605 E190/12/7 Aliens 16221 29 Dec 1621-24 Dec 1622 E190/25/2 Aliens 1632 29 Dec 1631-24 Dec 1632 E190/37/6 Aliens 1639 Christmas 1638- Christmas

1639 E190/43/62 Denizens

1662-63 Michaelmas 1662 to Michaelmas 1663

CO 388/2, f.7 All

1664 Incomplete: 12-27 Jan 1663/4; 16 April-2 Sept 1664; 7 -26 Nov 1664.

E190/50/2 Denizens

1668-69 Michaelmas 1668 to Michaelmas 1669

CO 388/2, f.13 All

1686 24 Dec 1685-24 Dec 1686 E193/139/1 Denizen 1686 24 Dec 1685-24 Dec 1686 E193/141/5 Alien

NB: I have excluded 1669-70 Alien exports as it covers a brief period. 1 Another surviving book for this year (E190/25/9) records cloth exports only. 2 This volume is damaged and a significant amount of entries for October (c.25 per cent) and November (c.50 per cent) are illegible or lost

37

Appendix B: Medical Drug Sample Medical Drugs sample Medical Drugs with valuations from 1660 Rate Book: Acacia; Acorus; Adiantum; Adiantum Album; Agaric; Agaric, Trimmed; Agnus Castus; Alcanet; Alchermes, Confectio; Alkermes Syrrup; Aloes Cicotrina; Aloes Epatica; Ambergrease; Ameos Seed; Anacardium; Angelica; Aristolochia; Asaraum; Aspalathus; Assafoetida; Balaustium; Balsalum Artificial; Balsalum Natural; Bayberries; Bdellium; Ben Album Or Rubrum; Benjamin; Bezoar Stone (E Indies); Bezoar Stone (W Indies); Bolus Communis & Armoniacus; Bolus Venis; Bunkins, Holliwortles, Or Pistolachia; Callamus; Camphor, Refined Or Not; Caneri Oculus; Cantharides; Carolina; Carpo Balsami; Carrabe; Cassia Fistula; Castoreum; Cetrach; China Roots; Ciperus Longus & Rotundus; Civet; Coculus Indiae; Coloquintida; Cortex Guiaci; Cortex Mandragorae; Cortex Tamarisci; Cortex Winteranus; Costus; Cuscuta; Cyclamen; Cyperus Nuts; Cytrauge; Diagredium; Dictamnus Leaves; Dictamnus Roots; Dictamnus, Unspec; Doronicum; Ebustum; Elleborus (Black or White); Epithium; Euphorbium; Fennel Seed; Fenugreek; Flory; Folium Indiae; Fox Lungs; Galanga; Galbanum; Generall; Gentiana; Grana Pinae; Guinea Grain; Gum Animi; Gum Armoniac; Gum Caramen; Gum Carannae; Gum Elemni; Gum Guiaci; Gum Hederae; Gum Juniper; Gum Opoponax; Gum Sandrack; Gum Sarcocoll; Gum Serapium; Gum Taccamahaccae; Gum Tragacanth; Hermodactilis; Hypocistis; Incense; Ireos; Jalap; Jujubes; Labdanum; Lapis Calaminaris; Lapis Contrayerva; Lapis Hematitis; Lapis Judaicus; Lapis Tutiae; Leaves Of Violet Or Flowers; Lentiscus, Or Xylobalsamum; Lignum Aloes; Lignum Asphaltum; Lignum Nephriticum; Lignum Rhodium; Lignum Vite; Locust; Lupines; Manna; Mastick Red; Mastick White; Mechoacan; Milium Solis; Mirabilanes; Mirabilanes Condited; Mithridatium Venetiae; Mummia; Myrtil Berries; Nardus Celtica; Nigella; Nitrum; Nux Cupressi; Nux De Ben; Nux Vomica; Ol Amber; Ol Almonds; Ol Bay; Ol Ben; Ol Mace; Ol Petroleum; Ol Rosemary; Ol Scorpions; Ol Spike; Ol Terbinthinae; Opium; Orabus; Orange Flower Ointment; Orcant Or Almiet; Origanum; Osipium Huirredum; Ossa De Corde Cervi; Pellitorie; Perrosen; Pionyseed; Pix Burgundiae; Polipodium; Polium Montanum; Pomegranate Pills; Poppyseed; Psyllium; Radix Contra Yerva; Radix Esula; Radix Peonae; Rhaponticum; Rhubarb; Rose Leaves; Rosset; Sal Germine; Sandaracha; Sandiver; Sanguis Draconis; Sanguis Hirci; Sarsaparilla; Sassafras Roots; Sassafras Wood; Saunders White; Saunders Yellow; Scammony; Scordium; Scorzonera; Sebestens; Seler Montanus; Semen Cumeris or Cucurbis Citru, Melon; Senna; Soldonella; Spermaceti Course Oily; Spermaceti Fine; Spica Celtica; Spica Romana; Spikenard; Spodium; Squilla; Squinathum; Staechados; Stavesaker; Stibium; Storex Calida; Storex Liquida; Sulphur Vivum; Tamarindes; Terra Lemnia; Terra Sigillata; Thlaspi Semen; Tornsall; Treacle; Treacle Of Venice; Trocisci De Viper; Turbith; Turbith Thapsiae; Viscus Quercinus; Wormseed; Zedoaria; Medical Drugs with valuations from 1725 Rate Book: Adeps Ursi; Ambra Liquida; Auriculae Judae; Baccae Alkakengi; Balsam Capivia; Bitumen Judiacum; Capita Papaverum; Chamaepitys; Chelae Cancrorum; Cornu Cervi Calcinatum; Cornu Unicornu; Cortex Cariophyllorum;

38

Cortex Elutheris; Cortex Limonum Vel Aurantiorum; Cowitch; Cranium Humanum; Dens Apri; Dens Equi Marini; Eboris Rasurae; Eryngo; Flores Chamaemeli; Flores Meliloti; Granadilla Peruviana; Gum Copal; Hungary Water; Hypocacuana; Jesuits Bark; Lapis Hibernicus; Lapis Hyacinthus; Lapis Ostiocolla; Lapis Spongiae; Ol Carui; Ol Chemical; Ol Cimyni; Ol Origanum; Ol Perfumed; Ol Rhodium; Ol Thyme; Ol Cariophyllorum; Ol Anniseed; Ol Jessamin; Ol Juniper; Ol Sassafras; Ol Cinamon; Pompholix; Radix Bistortae; Radix Cassumuniar, Not Of The East Indies; Radix Enulae Campanae; Radix Mei; Radix Phu; Radix Tormentillae; Rezina Scamonii; Rezini Jallapi; Rhinhurst; Rosa Solis; Saccarum Saturne; Sal Prunellae; Sal Succini; Sal Tamarisci; Sal Volatile Cornu Cervi; Sevum Cervinum; Snake Root; Spa Water; Spiritus Cornu Cervi; Ungulae Alcis; Water, Cordial; Water, Pyrmont. Rate Book Drugs: This sample includes the Medical Drug sample listed above, plus these commodites with valuations from 1660 Rate Book: Almonds Bitter; Alum Plume; Alum Roche; Amomi Semen; Antimonium Crude; Argentum Vivum; Arsenic (Or Rosalgar); Barley Huld; Black Lead; Blatta Bizantiae; Borax In Paste; Borax Refined; Cambogiam; Cardomomes; Carraway Seed; Carthamus Seed; Cassia Lignea; Cerussa; Chrystal, In Broken Pieces; Ciceres; Cinabrium; Copperas, Blue; Copperas, White; Coral (Red And White); Coral Whole; Corriander Seed; Cortex Caperum; Cubebs; Cumin Seed; Daucus; Gardenseed; Ginny Pepper; Grana Tinctorum; Green Ginger; Gum Arabeck; Gum Lack; Gum Seneca; Isinglas; Juniper Berries; Lapis Lazuli; Lentils; Litharge Of Gold; Litharge Of Silver; Marmelade; Mercury Precipitate; Mercury Sublimate; Musk; Musk Cods; Myrrh; Nutmegs Condited; Olibanum; Orpiment; Panther; Pearl, Beaten; Pepper Long; Pistacias; Precipitat; Prunellos; Quicksilver; Rubia Tinctorum; Sal Alkali; Sal Armoniacum; Sal Niter; Saunders Red alias Stock; Seeds for garden; Sponges; Succus Liquoritiae; Talk, Green; Talk, White; Tumerick; Turpentine Common; Turpentine Of Venice; Umber; Varnish; Verdigrease; Vermilion; Vitriolum Romanum; White and Red Lead. And these with valuations from the 1725 Rate Book: Aqua Fortis; Barbados Tar; Cinnabaris Nativa, not of the East Indies; Colophonia; Cream Of Tartar; Essence Of Lemons; Fechia; Lapis Magnetis; Lapis Nephriticus; Lapis Rubinus; Lapis Sapphirus; Lapis Smaragdus; Lapis Topazae; Mother Of Pearl Shells, Not Of East Indies; Ol Nucis; Ol Palm; Ol Vitriol; Sal Tartari; Sal Vitrioli; Sal Volatile Armoniaci; Salop; Spiritus Vitrioli; Tartarum Vitriolatum; Turpentine of Germany. Additional ‘Medical’ items imported, These commodities were not rated and are not used in samples: Alligante; Althea; Amber Water; Angelica Water; Apoplectick Balsome; Balsam Tolu; Balsam, Peruvian; Balsam, Spanish; Bulter Pomatum; Cardas Water; Cascarilla; Cassia Buds; Cassia Stones; Cinamon Water; Cinquefoil Seed; Confection Of Hyacinths And Alkermes; Eagle Stones; Ginseng Root; Goa Stone; Granadilla Wood; Gum Of Almonds; Hartshorn; Lapis Aquilegii; Lapis Ashocula; Lapis Granati; Lemon Water; Nux Indica; Ol Capenia; Ol Cloves; Ol

39

Medicinal; Ol Physical; Opoponax; Orange Flower Water; Orange Ointment; Origano Oyl; Orrass Roots; Orvietan; Oyl Cloves; Physick Water; Pink Roots; Quatro Semina Frigidorum; Queen Of Hungary'S Water; Radix Cyprus; Radix Ffsarium; Radix Jessamin; Radix Tiberus; Radix, Columba; Scincus Marinus; Scorpions; Semen Ben; Semen Gingslam; Semen Secelees; Succus Cassia; Surgeon's Instruments; Syrup Of Maidenhair; Treacle Of Genoa; Tuberose Roots; Vipers; Water, Aniseed; Water, Broom; Water, Citron; Water, Ratafie; Worm Powder.

40

Appendix C: Annual Values of Main Imported Drugs

1567

i15

88i /8

9ii

1600

ii16

09II

1617

II16

21I

1624

II16

29I

1633

1638

1662

‐8 

(av)

1685

1699

‐170

1(av)

lb0

4814

513

111

146

240

1,57

346

500

5031

7

icot

rina

lb0

750

6356

00

3024

022

019

,005

22,1

6420

,394

ica

lb0

360

00

00

00

112

02,

867

15,4

912,

007

ase

oz0

00

00

270

00

01,

025

274

334

inlb

04

058

00

1,11

10

456

482

728

17,7

3710

718

,679

one

(E In

dies

)oz

00

00

2021

00

00

209

11,

103

tula

lb0

910

800

060

712

410

346

867

2,07

53,

805

5,26

94,

078

oots

lb0

300

752

5084

90

417

1,22

324

45,

339

10,8

2118

,271

gaca

nth

lb0

440

065

2,93

016

61,

818

6,12

52,

800

19,9

0011

,286

4,06

4

lb1,

176

00

00

746

490

13,1

7118

,368

4,84

40

504

9,89

7

Vite

cwt

288

00

00

040

520

60

1,06

535

84,

653

lb0

00

60

1,86

60

12,8

8222

21,

643

4,07

418

02,

007

lb20

40

012

1,34

992

2,50

032

53,

249

3,19

88,

952

2,07

0

Dra

coni

slb

056

90

00

00

448

280

00

1,70

32,

269

arilla

lb0

130

03,

750

01,

390

550

400

5,18

84,

650

1,31

516

,749

11,0

20

as R

oots

lb0

00

030

7,03

00

042

60

01,

736

10,6

05

ony

lb0

114

00

010

033

9,87

022

350

11,

955

2,89

81,

496

lb87

524

50

365

03,

725

1,36

20

7,43

04,

470

15,7

7725

,263

20,8

84

eltic

alb

03,

696

00

00

00

00

04,

592

0

lb0

50

08

294

602,

206

00

3,01

90

1,88

5

alid

alb

00

00

019

70

120

00

180

4,05

81,

196

mlb

025

012

00

098

00

00

0

lb7,

555

6,70

00

084

00

00

00

6022

9 17

22‐24 

(av)

1752

‐54 

(av)

1772

‐74 

(av)

Aga

ric92

00

1,77

3

Alo

es C

5,08

45,

296

77

Alo

es E

pat

48,1

1717

,265

8,65

0

Am

berg

re6

185

35,7

69

Ben

jam

13,7

9126

,323

7

Bez

oar S

t5

593

30,0

88

Cas

sia

Fis

1,04

31,

568

0

Chi

na R

23,1

636,

892

1,88

6

Gum

Tra

4,62

82,

379

18

Ireos

5,43

15,

660

9,26

4

Lign

um59

112

,073

6,92

0

Opi

um1,

475

629

14,2

51

Rhu

barb

2,29

024

,258

2,09

1

San

guis

073

812

,661

Sar

sap

1,26

249

,831

3,38

9

Sas

safr

188,

168

116,

005

73,0

84

Sca

mm

2,03

21,

036

38,1

28

Sen

na34

,919

30,7

2622

5

Spic

a C

00

59,9

99

Spi

kena

rd82

50

0

Sto

rex

C33

325

046

3

Sul

phur

Viv

u0

4624

8

Trea

cle

00

237,

678

Wor

mse

edlb

791

280

076

02,

232

10,4

9726

516

,372

16,9

449,

068

15,4

406,

969

17,6

636,

732

30

Man

nalb

245

017

725

136

078

20

2,06

367

00

27,4

886,

682

18,0

6833

,230

426

Oyl

Ann

isee

dlb

00

00

00

00

00

099

12,6

9014

163

132

,318

Jala

plb

00

00

00

025

240

00

07,

042

6,27

215

,694

576

Jesu

its B

ark

lb0

00

00

00

00

00

2,77

82,

045

76,0

7198

,820

2,95

3

Wat

er, P

yrm

ont

lb0

00

00

00

00

00

00

00

37,4

15

Cam

phor

, Unr

efin

edlb

00

00

00

00

00

928

1,71

146

024

,549

0

41

42

Note: Drugs included are the ‘top ten’ drugs by value for the periods given in Table 3. Partial totals for 1588 (English merchants) and 1589 (Alien merchants) are summed. For 1662-8 the total is an average of 1662-3 and 1668-9. For 1699-1774, the three year average for each sample period is given. No other adjustments have been made to compensate for the partial coverage of the early years. i. Port Book only contains imports by English Merchants; ii. Port Book only contains imports by Foreign Merchants.

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